| National Provider Identifier [NPI]: | 1215983085 |
| Last Name Of The Provider | SPELL |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2704 N OAK ST BLDG D |
| Street Address 2 Of The Provider | |
| City Of The Provider | VALDOSTA |
| Zip Code Of The Provider | 316021738 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 7296 |
| Number Of Medicare Beneficiaries | 3853 |
| Total Submitted Charge Amount | 736560 |
| Total Medicare Allowed Amount | 208059.87 |
| Total Medicare Payment Amount | 156132 |
| Total Medicare Standardized Payment Amount | 162910.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 171 |
| Number Of Medical Services | 7296 |
| Number Of Medicare Beneficiaries With Medical Services | 3853 |
| Total Medical Submitted Charge Amount | 736560 |
| Total Medical Medicare Allowed Amount | 208059.87 |
| Total Medical Medicare Payment Amount | 156132 |
| Total Medical Medicare Standardized Payment Amount | 162910.26 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 853 |
| Number Of Beneficiaries Age 65 to 74 | 1518 |
| Number Of Beneficiaries Age 75 to 84 | 1046 |
| Number Of Beneficiaries Age Greater 84 | 436 |
| Number Of Female Beneficiaries | 2442 |
| Number Of Male Beneficiaries | 1411 |
| Number Of Non Hispanic White Beneficiaries | 2741 |
| Number Of Black or African American Beneficiaries | 1021 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2661 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1192 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6195 |